SERIAL BIOCHEMICAL AND HISTOLOGICAL STUDIES ON FATTY LIVER IN OBESE PATIENTS

The biochemical and histological features were investigated in 22 patients with fatty liver accompanied with obesity. In biochemical studies, Serum-GOT, GPT, Cholinesterase, Albumin, Triglyceride and ICG R15 were frequently abnormal before therapy for obesity. These parameters, however, recovered after the therapy and were thought to be good markers for following these fatty liver patients. In light microscopic examination, there were two subgroups showing different histological abnormalities: one with only steatosis and the other with hepatic fibrosis in addition to steatosis. There was no difference in period for recovery of biochemical values between two groups, however, histological abnormalities lasted longer in those patients with fibrotic changes other than steatosis alone even after normalization of biochemical tests. In electron microscopic observation, dilatation of the endoplasmic reticulum and Golgi apparatus, swelling of the mitochondria were found in the hepatocyte. These findings disappeared in response to the therapy. In addition to these hepatocytic changes, fibroblast-like Fat-storing cells (FSC) appeared to be increased around collagen bundles in patients with hepatic fibrosis, which may suggest a close relationship between FSC and collagen synthesis.